Acute Pelvic Pain Flashcards

1
Q

Differentials

A
Ectopic pregnancy
Ovarian Torsion 
Fibroid degeneration 
PID exacerbation
Tubo-ovarian abscess 

Endometriosis
Endometrial polyps

IBS
Interstitial cystitis
Renal colic

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2
Q

Ovarian torsion presentation

A

Fluctuating sharp pains before acute onset severe constant pain
Radiates to back
N+V

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3
Q

Ovarian torsion investigations

A

Basic obs
Bloods - Ca 125, CRP, WCC
USS

  • Act before investigations based of of clinical exam
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4
Q

Clinical examination for ovarian torsion

A

Guarding
Abdominal tenderness
Rebound tenderness

Cervical excitation
Adnexal tenderness
Adnexal mass

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5
Q

Ovarian torsion treatment

A

Admit
IV fluids
Pain relief
Surgery

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6
Q

Why does fibroid degeneration occur in pregnancy

A

Oestrogen increases

Increases size of fibroid

Outgrows blood supply

Degradation

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7
Q

Most common cause of PID

A

Chlamydia

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8
Q

Tubo-ovarian abscess investigations

A
Pregnancy test 
Bloods - FBC, CRP, WCC, HCG
TV USS 
First void urine  NAAT 
STI screening 
Abdominal Xray
Diagnostic laparoscopy
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9
Q

Mx of tubo-ovarian abscess

A

IV abx

IM ceftriaxone + oral doxycline bds + metronidazole bds for 14 days

Surgical drainage

Counselling - risk of infertility

Partner notification for STI

4 hourly observations

Follow up

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10
Q

Haematocolpos

A

Accumulation of blood within the vaginal due to an imperforate hymen

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11
Q

Haematocolpos presentation

A

Cyclical pain

Delayed menarche - no bleeding

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12
Q

Haematocolpos examination findings

A

Speculum - Blueish discolouration at introitus

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13
Q

Haematocolpos treatment

A

Cruciate incision

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